Provider Demographics
NPI:1619153541
Name:THOMAS-ST. CYR, AISHA QUAMA (MD)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:QUAMA
Last Name:THOMAS-ST. CYR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 BAY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3282
Mailing Address - Country:US
Mailing Address - Phone:772-388-9155
Mailing Address - Fax:772-238-8915
Practice Address - Street 1:7955 BAY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3282
Practice Address - Country:US
Practice Address - Phone:772-388-9155
Practice Address - Fax:772-388-9154
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115531207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease